Table of Contents
Definition / general | Case reports | Gross description | Gross images | Microscopic (histologic) description | Microscopic (histologic) images | Positive stains | Negative stains | Differential diagnosisCite this page: Ehdaivand S. Steroid cell tumor. PathologyOutlines.com website. https://www.pathologyoutlines.com/topic/ovarytumorsteroidcelltumorNOS.html. Accessed June 9th, 2023.
Definition / general
- < 0.1% of all ovarian tumors
- Mean age 42 years, range 2 to 80 years
- Usually associated with androgenic changes (56-77%); estrogen secretion in 6-23%, Cushing syndrome in 6-10%
- Usually benign in prepubertal children
- Clinically malignant in 25-43%, associated with 2+ mitosis per high-power field (92% malignant); necrosis (86% malignant); 7 cm or larger (78% malignant); hemorrhage (77% malignant); and grade 2 or 3 nuclear atypia (64% malignant); some clinically malignant cases are histologically benign (Am J Surg Pathol 1987;11:835)
Case reports
- 8 year old girl with virilization (Arch Pathol Lab Med 1991;115:150)
- 22 year old woman with virilization, acute onset of severe hyperandrogenism (J Med Case Rep 2007;1:182)
- 24 year old woman with hirsutism and multiple sclerosis (Arch Pathol Lab Med 2003;127:890)
- 29 year old woman with virilization and tumor in accessory ovary in broad ligament (Arch Pathol Lab Med 1996;120:405)
- 35 year old woman with virilization and a pelvic mass (Arch Pathol Lab Med 2006;130:113)
Gross description
- Up to 45 cm, solid, well-circumscribed, yellow-orange to red-brown to brown-black cut surface (depending on amount of lipid and lipochrome pigment)
- 6% bilateral; occasional hemorrhage and cystic degeneration
Gross images
AFIP images
Lobulated and yellow-orange
Dark brown with large amount of intracytoplasmic lipochrome pigment
Necrosis, hemorrhage and cystic degeneration
Images hosted on other servers:
Tan brown, well circumscribed tumor with hemorrhage
Microscopic (histologic) description
- Usually diffusely arranged cells, also nests, clusters, cords and columns
- Scant stroma may be fibromatous, edematous or myxoid
- Tumor cells are round / polygonal with spongy to granular, eosinophilic cytoplasm with clear intracytoplasmic vacuoles
- Distinct cell borders; central nuclei, prominent nucleoli
- No Reinke crystals, no significant nuclear atypia or mitotic activity
Microscopic (histologic) images
AFIP images
Diffuse pattern
Growing in large aggregates
Round tumor
cells, uniform
nuclei, prominent
nucleoli
Abundant pale (lipid-rich) cytoplasm
Abundant lipid (oil red-O stain)
Two atypical mitotic figures
Images hosted on other servers:
Diffuse sheets of large
polygonal cells: vacuolated
cytoplasm, vesicular nuclei
and nuclear pleomorphism
Positive stains
- Inhibin, fat stains (75%), vimentin (75%), CAM 5.2 (46%), AE1/AE3 (37%), EMA (8%) and S100 (7%)
Negative stains
- Chromogranin A, CD15 (Leu-M1), myoglobin, neurofilament, AFP, CEA and HMB-45
Differential diagnosis
- Clear cell carcinoma
- Luteoma of pregnancy
- Metastatic renal cell carcinoma
- Stromal luteoma
